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6 wk old-poor weight gain

I am a mother of 6 currently trying to breastfeed a 6 wk old. He weighed 6# 7oz at birth and lost about 12 ounces the first few weeks. He has been followed by the doctor and weighed weekly. At 4 weeks he was back to birth weight and now at 6 wks weighs 7#. For the first 4 weeks I breastfed and gave occasional bottles of my expressed milk, but at 4 wks the doctor asked me to start formula supplements of 2 ounces at every feeding. He was still gaining with just the breast milk, but I guess not as fast as the doctor wanted. I started giving him 1 oz of breastmilk and 1 oz of formula at each feed, breastfeeding occasionally and through the night and was pumping. He was taking 7 oz of formula and 7 oz of breastmilk (for a total of 14 oz) in a 24 hour period. With pumping during this period I was getting 10-12 oz a day depending on how much I had put him to the breast. After the first week he has had about 10 wet diapers a day, but went 5 days without pooping then had a poopy diaper about everytime he was wet then went 10 days with no poop until I started the formula supplement. I did the formula supplement for about a week and after 5 days he gained 5 ounces. I am wanting to continue to just breastfeed and right now am only giving him about 2 ounces of pumped milk and 2 ounces of formula a day because I want to make sure my milk supply keeps up with him. He is still having at least 10 wet diapers a day and usually poops once a day, but might go a few days without. He breastfeeds for 10-50 minutes every 1-4 hours, but might go a little longer at night. I can feel the let downs-usually 2-3 in a longer feeding and can tell a difference in his sucking pattern. With just breastfeeding he seems to only be gaining 2-3 ounces in a week. I have also had a prescription for Reglan and have taken Fenugreek,Blessed Thistle, and Fennel off and on in case it is a supply issue. I really feel like I have plenty of milk-alot of times when he lets go milk just keeps coming out. My last 3 children have lost weight like this, about 12-16 ounces and around 4 weeks are usually back on the right track. The first one that did this started off so small I gave up on the breastfeeding and just gave formula. With my last one though we made it through this andI breastfed for 16 months. I am a smoker (1/2 a pack to a pack a day) and I drink quite a few caffeinated drinks, but feel like I am eating plenty and drink at least 100 ounces of other fluids during the day. I don't want to starve him and know that he should be gaining better than this by now, but also don't want to give up on breastfeeding him and am afraid of what will happen to my milk supply if I keep supplementing. I have read books and articles, but nothing that has helped or made me feel any better. And I know they say pumping isn't as effective as actually breastfeeding, but no matter how long in between feedings and even with my last child once I returned to work and would pump there I only get 2 ounces-3 if I'm lucky. If anyone else has experienced this or has any advice plaese let me know. Sorry for the novel.

Re: 6 wk old-poor weight gain

I would wean off the cigarettes b/c it comes through your breastmilk. Smokers don't have as much of an appetite as non-smokers maybe thats a reason. I quit smoking 3 years ago I know its hard especially with six kids, but its a good time to stop and a good reason.